Things you don't need to know…

April 29th, 2013, 12:39

Perhaps we can give meaning to the word, like: an avid gamer that spends the whole day playing games in a badly lit room that looks like a hole. He is the only person there as there is no one else that wants to live with him. People tell him he is a wholeoneley.

— Computern. A machine which flawlessly performs the instructions it is given, no matter how flawed those instructions may be.

If there was an "we can get a word" for Larian's DOS, then it would be a nice idea, I think.

— “ Any intelligent fool can make things bigger, more complex, and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction.“ (E.F.Schumacher, Economist, Source)

They (that's the group of hospitals he works for) want to obtain an archive for every image produced in the hospitals. And by every image, they mean every image. They (the group of hospitals he works for) already have PACS’essss (Preciousss… eh …Picture Archive and Communication Systems) for radiology and nuclear medicine. Now it’s about implementing an archive for all the other images: Endoscopy (fiberoptic tubes inserted into every natural, most of them yecchy, opening in your body), digital photos, pathology images and lots more. Including videos. And they (the group of hospitals he works for) want to be able to look at all these images in a viewer which can display several types of images simultaneously. Every clinician in even the darkest corners of the hospitals should be able to access images, subject to laws governing patient security. And they should be able to do it from the EPR (electronic patient record). They (the group of … oh bother) also consider migrating PACS images to the new archive, using it as a long time storage for radiology.

They want a VNA (Vendor Neutral Archive). Which for instance means that they should be able to access the images using widely different viewers, and not being locked to one single vendor. Another important aspect, in many ways the ultimate test of vendor neutrality, is what happens if they some time in the future want to replace the current VNA vendor with another one. In a VNA this should be easy, and especially not require copying images to yet another archive. This is important because migrating images is an expensive and very time consuming affair.

One example: In the PACS systems they have approximately 500 TB of image data, 6 million examinations, more than 100 million images. Now, copying 500 TB in itself shouldn't take that much time. But radiology images are more than bitmaps, they also store the context of the images, metadata, such as patient id, type of examination, the organ examined, details regarding how the images were acquired, sequence number if the image is part of a multi image study (CT, MRI…), and much, much more. Especially important are their connections to radiology information systems. Together, bitmaps and metadata constitute the image object, or as friends like to say: the DICOM object, after the standard covering storage of radiology images. Metadata is stored in so called DICOM tags. The standard specifies which tags should contain what information. However the standard also allows private tags, unofficial tags which may be used for whatever a vendor of radiology hardware and software would like to place there. And most vendors do exactly that. Which unfortunately makes DICOM objects from different vendors not 100% compatible, and complicates migration.

Migration images therefore involves more than just copying the bitmaps. Metadata must also be transferred, usually after some editing. (Although each DICOM object is one complete object, the objects are are usually splitted in storage, with the bitmaps stored as files, and the DICOM tags in a database). It has to be a tightly controlled process, they can’t risk connecting images to the wrong patient. All this takes time, at least several months. Additionally, despite all efforts, errors are bound to happen. It’s not funny, and it’s obviously not something one would want to do very often.

He went to Chicago last november, because he knows something about these things. And every year there is a huuuge radiology conference there, held by RSNA (Radiology Society of North America). It's THE RADIOLOGY CONFERENCE. Which means that every vendor of radiology equipment and software solutions who wants to sell lots of their things will be there. So he came, saw and talked to many people to help understanding what's possilble and how it could be done.

Now you know, tomorrow you most likely won’t bother. Just wait until pibbur tells you why he went to Baltimore, Phoenix, Atlanta and this autumn will be going to Boston.

Originally Posted by pibbur who
He went to Chicago last november, because he knows something about these things. And every year there is a huuuge radiology conference there, held by RSNA (Radiology Society of North America). It's THE RADIOLOGY CONFERENCE. Which means that every vendor of radiology equipment and software solutions who wants to sell lots of their things will be there.

Sounds to me a little bit like the equivalent of the E3.

— “ Any intelligent fool can make things bigger, more complex, and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction.“ (E.F.Schumacher, Economist, Source)

Some of you may remember that last week he claimed to be in Atlanta@Usa, and that he for years have given you the impression that he spends his days in Bergen@Norway. Both of these claims are correct.

But. Last Friday he boarded a plane heading towards Chicago, only to board a plane for Heathrow@London@UK. And from Heathrow it' s only 1 1/2 hour (by plane) to good ol' Flesland airport@Bergen@Norway, where he landed at 19 hours. Saturday.

The journey from Atlanta to Bergen wasn't entirely without complications. No Whitney Houston wannabe, but there were a few logistics problems. First, in Atlanta, he learned that flight 3617 for Chicago was delayed. Isolated, that was of little concern, since his plane was the 3616. But he figured that if 3617 was delayed, so might 3616 be. Which it was. So he asked the lady behind a counter what he should do. She said that he might just reach chicago in time for BA0296 heading for London. When he informed her that while 3616 was headed for terminal 3, 0296 would probably depart from terminal 5, she said: "Oh". Which definitely is not what you want to hear when discussing the consequences of delayed planes with ladys behind counters. (It reminded him of his surgery exam back in med school). Enter 5 minutes of frantic activity and stressful thinking, and he was rebooked to the last remaining seat on 3617, his luggage possibly rerouted to said plane, and running to gate where he arrived at gate just in time.

The cause of the delays was according to his sources, very inconvenient winds at O'Hare, which reduced the number of runways avaiable for planes. In fact, said sources mentioned it was the worst kind of winds for planes@O'Hare. Another thing you don't want to hear unless you consider turbulence the funny part of modern air travel. Pibbur doesn't.

He came (O'Hare), saw (the gates of O'Hare) and heard (from the lady at the gates of O'Hare) that the boinggg 777 heading for Heathrow would not do so for 4-5 hours. Which meant that 1) the above mentioned frantic activity and stress wasn't necessary, and 2) he would arrive at Heathrow 5 hours behind schedule. But no worries. He originally had 7 hours of transit time @ heathrow, so, unlike most of his fellow passengers, he would without doubt, catch his next plane (Nee-ne-nee-ne-neeee-neh!!), the 0760 to Norway. And, at O'Hare he had power for his laptop.

The reason 0296 was delayed was that one of the pilots planning to pilot the plane got sick and therefore wouldn't pilot the plane after all. They had other pilots who very recently piloted in from somewhere in Europe, but according to regulations and probably also the interest of the passengers (you don't want to hear snoring from the cockpit) they had to rest for a while before piloting again.

Well. Eventually he arrived at his home airport at 1900 pm, saturday evening. Just 11 hours before the plane leaving for Frankfurt took to the skies. With pibbur and family aboard, heading for Wien. To celebrate upcoming 60 year's birthday of the wife.

So here he is, at the moment of writing at Cafe Hawelka, eating sausages and drinking beer. He'll refer you to wikipedia regarding details of said cafe, but a visit to Wien is not a visit to Wien unless you visit Hawelka. Sort of.

Other things?

0218: Roman emperor in trouble.
1204: Roman emperor in trouble. Actually he's referred to as a latin emperor, whatever the difference. Who cares? He would still be in trouble.
1568: British queen in trouble.
1866: Half dime in trouble.
2007: France is in trouble.

There are no kangaroos in Austria.

Pibbur who realizes that he posted this in the wrong thread. But since it's mostly useless drivel, it may as well remain here.

Originally Posted by HiddenX
Austrians can be easily mistaken for Germans -

Hint for distinguishing: They can't play football

Good to know, in case I loose my map.

pibbur who like the Norwegian national team, can't play football either.

Since no one asked about the Whitney Houston reference (are you getting used to pibbur not making much sense?), here's the story from Huffington Post. It could have been much worse. It could have been something fram ms Spears. Or mr. Bieber. Or the Macarena.

One thing that's parzicular for Autrian Language is what I know as the "Wiener Schmäh". http://de.wikipedia.org/wiki/Wiener_Schm%C3%A4h It's very difficult to explain this in English, because I never really encountered/experienced it. It's said to be a special kind of Humour.

— “ Any intelligent fool can make things bigger, more complex, and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction.“ (E.F.Schumacher, Economist, Source)

Yepp. Health Level 7 it is. A standard for, surprise, surprise … Health … or more precisely: a standard for interoperability, for exchanging information between healthcare software solutions. The level 7 is a tribute to the 7th layer of the osi networking model.

The standard covers about every aspect of information exchange related to healthcare: patient demographics, patient administration, clinical information (for instance between a hospital and the doctor referring the patient), requests for an results from supplementary examinations like radiology and pathology. Clinical chemistry as well. And a lot more, including support for authentication, for maintaining confidentiality, security, and for auditing who did what with whose information.

The standard has been around for years, in the shape of version 2.x. There are several things wrong with version 2. It's not very readable. It's not based on a thoroughly developed information model. And there are too many options, which means that different operators use it differently. Which is bad.

Enter version 3. The foundation for version 3 is the RIM, the Reference Information Model. It's described in UML and it's huge. There are few things (health related) not covered by it. The model is supplemented by a set of datatypes, and a vocabulary, a set of standard terms and codes used to identify things within it. You can find more on it, including a picture here: http://www.hl7standards.com/blog/201…-intimidating/

In itself the RIM is too large and complex for practical use. In stead restricted (specialized) models are developed based on the RIM, so called RMIMs (Refined Message Information Model). These are adaptations covering specific types of information. One of them is CDA (Clinical Document Architecture). It covers storage and exchange of clinical information and results, whereas demographics (like a patient moving to a new address) and administration (for instance patient admittance to hospitals) are outside the model. It's implemented in XML, and it contains parts specifically designed to be human readable.

CDA is further adapted to different specialities. Thus there are or will be separate CDA's for instance for clinical reports to referring doctors after hospitalization, for transfer information with the patient from one institution to another, and for communicating results of supplementary exminations like ECG or an xray. Informatipon presented in an ECG report will be different from an xray report, but they're all based on the general CDA model (which again derives from the RIM)

Version 3 is still under development. The RIM itself is fairly stable by now, but there is still a lot to do regarding the RMIMs. And this is where pibbur comes in. Along with many others.

HL7 is governed by "Health Level 7 International". Much of the work is delegated to workgroups specializing in different aspects of the standard. 3 times a year workgroup meetings (WGM) are held. Mostly in the US, but occasionally they go abroad. They've been in Canada and Brazil. They've even gone to Australia. The may meeting in 2015 will be held in Paris.

At each WGM there are several training courses, but most important are the meeting of the workgroups. Pibbur attends two groups during these sessions. One of them is Order and Observation (OO), which is about ordering mostly clinical chemistry analyses and retrieving the results. The other is Imaging Integration (II) which covers results from xray examinations and other types of diagnostic imaging (like PET scanning). This is his favourite due to his many ears working as an administrator of PACS systems. And his 2 1/2 years as a radiologist wannabe. Pibbur may not want to work as a physician anymore (he definitely doesn't want that), it's still nice for him to be able to use some of his medical knowledge.

So far he's been to 3 WGMs in Baltimore, Phoenix and Atlanta. And in september he's scheduled for Boston.

Pibbur who now has finished his 2 pieces of longish drivel. Which you didn't need to know, but which pibbur, in the spirit of this thread, insisted on telling you.

PS. You may have noticed: HL7 people loooove acronyms. And now i'm going to share a secret with you. One of the RMIMs is called "Fast Healthcare Interoperability Resources" or … yepp … FHIR. But here's the deal: we pronounce it "fire". Don't ever pronounce it like "fur", unless you want to prove to everyonethat you're a newbie. You don't want that, do you? DS.

H7 ? Don't tell that Bioware. They'd change the N7 into an H7.
And then EA would claim a trade mark on the "H7".

— “ Any intelligent fool can make things bigger, more complex, and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction.“ (E.F.Schumacher, Economist, Source)

— “ Any intelligent fool can make things bigger, more complex, and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction.“ (E.F.Schumacher, Economist, Source)

Spring is here (should have been for some time, but we had snow 3 weeks ago). And when spring comes, so does grass. All the world was in tune on a bright afternoon when pibbur fired up his oh-so-powerful and somewhat noisy petrol powered lawn-and-everything-in-it-mower, which he for obvious reason calls Rammstein.

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pibbur who plans on firing up Rammstein several times this season. Without warning.

First they demoted Pluto from planet to dwarf planet (planet wannabe). Now they try to demote Archaeopteryx from first bird to next-to first. Some say even next-to-next-to-next-to first bird, as there are two more (which I refuse to mention) claimed to be older. The main usurper is Aurornis xui, estimated to be 10 million years older than Archaeopteryx.

All according to Wikipedia.

*sighs*

pibbur who notices that due to the demoting of Pluto, Gustav Holst's "The Planets" becomes accurate again.